Recommended Preventive Health Screenings for Women
(recommended by the U.S. Preventive Services Task Force and the Agency for Healthcare Research and Quality)
Well-woman visit Annual preventive care visits are recommended for women age 20 and older.
Thyroid test Recommended for women 60 years and older, as well as women planning to get pregnant and anyone at increased risk.
Bone Health At least once beginning at age 65; or earlier depending on your risk factors for osteoporosis.
Mammogram Every 1-2 years starting between ages 40-50 (guidelines vary; talk to your health care provider about your risks and benefits). Continue annual or biennial screenings through at least age 74.
Clinical Breast Exam About every 3 years for women in their 20’s and 30’s and every year for women 40 or older. Talk with your health care provider about what is appropriate for you.
Colonoscopy (and/or other screening tests for colorectal cancer, such as fecal occult blood testing, flexible sigmoidoscopy and CT colonography) starting at age 50. You may need to be screened earlier if you have a family history of colorectal cancer. Talk with your doctor about which test is best for you.
Fasting Plasma Glucose Test Screening guidelines generally recommend every 3 years beginning at age 45, except for adults with increased risk for diabetes, who may be tested regularly starting at any age. Those with high risk factors should be tested more frequently.
Blood Pressure Screening Beginning at age 18, at least every 2 years. If your blood pressure is 120/80mm Hg or higher or you have other heart risks, screen more frequently.
Cholesterol Screening Begin screening at age 20 for women at increased risk for heart disease, otherwise, talk with your doctor about an appropriate time to begin screening.
Reproductive Health Screenings Pap test every 3 years for women ages
21-29: For women 30-65, Pap test and HPV test every 5 years or Pap test alone every 3 years. Testing may be stopped at age 65 or 70 for women who have 3 or more normal Pap tests in a row.
Sexually Transmitted Diseases Talk with your doctor about appropriate screenings, especially if you have or have had multiple sex partners.
Immunizations Influenza Vaccine should be given annually to everyone 6 months and older. Check with your doctor about other regular vaccinations appropriate for you or your children.
How Do I Know Which Health Services Are Covered?
If you have a health insurance plan through a Health Insurance Marketplace, your insurance will cover the preventive services and at least 10 essential health benefits (see list below) required by the Affordable Care Act (Obamacare). Beginning in 2015, the Affordable Care Act required that every health plan would cover all costs related to preventive services. Coverage can vary from state to state. Preventive services, such as those listed on the reverse side of this sheet, are those screenings that can detect disease or help prevent illness or other health problems.
You can view a complete list of preventive services covered by insurance plans that meet ACA requirements at:
https://familydoctor.org/health-insurance-understanding-covers-full-list-preventive-services/
Essential Health Benefits covered under the Affordable Care Act
(These essential benefits are covered differently than the preventive services listed on the reverse side of this sheet. Your insurance will not cover ALL costs for these benefits listed below. You will likely have co-pays and deductibles for these services.)
• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Hospitalization (such as surgery)
• Maternity and newborn care (care before and after your baby is born)
• Mental Health and substance abuse disorder services, including behavioral health treatment
(this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with
injuries, disabilities, or chronic conditions gain or recover physical/mental skills)
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care (this does not include adults)
• Birth control coverage
• Breastfeeding coverage
Keep in mind that a medical necessity is not the same as a medical benefit. A medical necessity is something that your doctor has decided is necessary. A medical benefit is something that your insurance plan has agreed to cover.
Your doctor will do his or her best to be familiar with your insurance coverage so he or she can provide you with covered care. However, it is best for you to become familiar with your specific insurance plan. Some kinds of care may need to be approved by your insurance company before your doctor can provide them.
If you have contacted your insurance/doctor’s office and still have coverage questions please call Kim Hulme at 208-847-0949 for further assistance.
